Provider Demographics
NPI:1043298938
Name:HIURA, RONALD NEAL (OD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:NEAL
Last Name:HIURA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 POLK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4616
Mailing Address - Country:US
Mailing Address - Phone:415-776-2352
Mailing Address - Fax:415-776-5872
Practice Address - Street 1:1418 POLK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4616
Practice Address - Country:US
Practice Address - Phone:415-776-2352
Practice Address - Fax:415-776-5872
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6956152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0069560Medicaid
CAT10445Medicare UPIN
CASD0069560Medicaid
CAP00927028Medicare PIN
CA5103200001Medicare NSC